Integumentary Problems

  1. Causes of cellulitis
    • Break in protective skin barrier
    • Bacteria enters, releases toxins into dermis and subcutaneous tissue
    • Spreads through tissue spaces
  2. Clinical manifestations of cellulitis
    • Acute onset of swelling
    • “Localized” redness and pain
    • Deep red erythema
  3. Systemic Signs of cellulitis
    Fever, chills, sweating, tachycardia, hypotension
  4. In cellulitis what would you find tender and enlarged?
    Regional lymph nodes
  5. What are some conditions that make older clients susceptible to cellulitis?
    • Decreased resistance
    • Malnutrition
    • long term corticosteroid use
    • malnutrition
  6. How is a mild case of cellulitis treated ?
    on an outpt basis with oral Antibiotics
  7. How is a severe case of cellulitis treated?
    IV antibiotics 7-14 days
  8. What would you teach a patient about the treatment of cellulitis?
    • prevention of recurrent episode
    • Antibiotic treatment compliance
    • Use a warm, moist compresses to site every 2-4 hours
  9. What is psoriasis?
    • Chronic, non-infectious
    • erythematous skin disorder with inflammation
  10. What are characteristics of psoriasis?
    • Occurs in patches
    • Genetic systemic disease
    • Characterized by remissions and exacerbations
    • Cells pile up and form lesions instead of shedding
  11. What are causes of psoriasis?
    • Epidermal trauma
    • Streptococcal infections
    • Genetics
  12. Clinical manifestations of psoriasis?
    • Epidermis is thickened with extra skin cells
    • Skin cells pile up
    • bilateral symmetry common
    • Dead cells create a white flaky layer of silvery white scales over a patch of inflamed skin
  13. What happens If scales are scraped away in psoriasis?
    a dark red base of the lesion is seen
  14. What are the bleeding points seen in psoriasis?
    • Commonly on elbows
    • knees, scalp, genital and sacral areas
    • palms, soles, and fingernails
  15. List some risk factors for psoriasis? (3)
    • Stress
    • Climate Changes
    • Hormones
  16. Diagnostic testing for psoriasis?
    Skin Biopsy
  17. What is the result of a positive skin biopsy for psoriasis?
    Increased Serum uric acid levels
  18. How is psoriasis treated?
    • Medical Management
    • Suppress the immune system
    • Retinoids
    • Artificial UVL—photosensitizing
    • Drugs to promote peeling
  19. Topical therapies for psoriasis
    • Coal Tar (Anthralin)
    • Corticosteroids
    • Occlusive dressing: med to area, covered with plastic wrap
  20. Nursing Interventions for psoriasis
    • Assist client with altered self concept
    • Infection prevention from open lesions
    • Keep lesions clean and dry
    • Rx ointment and creams with occlusive dressings
  21. What is herpes zoster (HSV) / Shingles
    • Acute Viral infection of nerve structure caused by Varicella Zoster
    • Activation of dormant Varicella Zoster Virus
  22. What are some causes the herpes zoster/shingles?
    • Chemo induced immunosuppression
    • Hodgkin’s Lymphoma
    • Debilitating Disease
  23. HSV/SHINGLES is related to the ___________.
    chicken pox virus: Varicella
  24. Who is at risk of getting HSV/Shingles?
    anyone who has NOT had chicken pox or who is immunosuppressed
  25. What does the HSV/Shingles look like?
    • Linear patches of vesicles with an erythematous base
    • Follows nerve pathway
    • Spinal and cranial tracts
    • Often unilateral, appears on trunk, can appear on face
  26. Assessment findings of HSV/Shingles
    • Neuralgia
    • Malaise
    • Pruritis (itching) \Burning
    • Erythema, clustered skin vesicles
    • Fever
    • Paresthesias often long term
    • Skin culture reveals organism
  27. Where will the pain, burning & neuralgia occur with HSV/shingles?
    At the site before the outbreak of vesicles
  28. How will you treat HSV/Shingles?
    • Analgesics
    • Cool compresses,
    • Tepid baths
    • Anti-anxiety agents
    • Benadryl
    • Zovirax, Interferon
  29. You will assess these for HSV/Shingles
    • Assess pain levels, medicate, re-eval
    • Neurovascular assessments
    • Neurologic Status
  30. Candidiasis is a ___________ infection?
  31. What type environment does Candidiasis like?
    Warm, dark, moist environment
  32. What areas of the body are you more likely to see Candidiasis?
    • skin folds
    • groin area
    • mouth
    • vagina
  33. What does candidiasis look like?
    • White, cottage cheese curds resemblance
    • Check skin folds
  34. Causes of Candidiasis?
    • Seen in immunosuppressed clients
    • Overuse of Antibiotics
  35. Medical/Nursing Mgmt of candidiasis?
    • Skin Hygiene…assess, assess. assess
    • Keep folds dry, clean and open to air
  36. Drug treatments for Candidiasis?
    • Nystatin
    • anti-fungal powders or swish and swallows
Card Set
Integumentary Problems
skin infections